Guest guest Posted March 21, 2011 Report Share Posted March 21, 2011 Orthopedic surgeons, orthotists work together to treat Charcot-Marie-Tooth disease http://www.orthosupersite.com/view.aspx?rid=81786 ORLANDO, Fla. — Both surgical and orthotic options can be indicated for ideal treatment of patients with Charcot-Marie-Tooth disease (CMT), according to presenters at the 2011 Annual Meeting and Scientific Symposium of the American Academy of Orthotists and Prosthetists. Patients with CMT ultimately benefit from the use of a multidisciplinary team because of the separate and specific roles that orthopedic surgeons and orthotists play in their treatment. F. Conti, MD, director of the division of foot and ankle surgery at Allegheny General Hospital in Pennsylvania and associate professor of orthopedic surgery at Drexel University College of Medicine, said he appreciates working with orthotists for that reason. E. Shy, MD, neurology specialist at Harper University Hospital in Detroit and professor of neurology at Wayne State University School of Medicine, provided some background on the disorder. He noted that there are 40 genes that can cause inherited neuropathies, and studies show that up to 10% of the population has a peripheral neuropathy. CMT is one of the genetic disorders, and can be traced directly to its source in many instances. Given this information, Shy said that patients and their families want to know who else in their family is at risk. " It matters to families, knowing the [likelihood of] inheritance for CMT, " he said. Responding to audience questions, Conti said that, as orthotists, the patient's ultimate diagnosis is irrelevant to the treatment. " You don't need the diagnosis, " he said. " You need the technical diagnosis. " McKale, CO, LO, practice manager of Midwest Orthotic and Technology Center in Chicago and Merrillville, Ind., agreed, saying, " The diagnosis is almost unimportant. " He urged orthotists not to get caught up in that aspect of treatment and, instead, provide the patient with the best device and care possible. " We need to be concerned with the overall picture of the person and what we're seeing when we're treating these patients, because ultimately the decisions we are making as orthotists affect the outcome, " he said. " If we're not making the proper decisions then that outcome is not going to be what the patient wants and the brace is going to get thrown on the shelf. " Making the decision for surgical options also affects the use of orthoses. Treating a patient at the level of early supple deformity might indicate trying orthotic intervention as the best option. However, a patient at the same level also might be the best candidate for tendon transfer surgery to rebalance foot, Conti said. Another benefit of surgery, he said, is that it might not completely eliminate the need for an orthosis, but downgrade the level of orthosis necessary for treatment. Quote Link to comment Share on other sites More sharing options...
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